Impact of Body Mass Index and Waist-to-Hip Ratio on Clinical Outcomes in Patients With ST-Segment Elevation Acute Myocardial Infarction (from the Korean Acute Myocardial Infarction Registry)

Lee, Sangeun; Park, Jong Seon; Kim, Woong; Shin, Dong Gu; Kim, Young Jo; Kim, Dong Su; Choi, Dong‐Ju; Han, Kyoo Rok; Kim, Chong Jin; Cho, Myeong Chan; Chae, Shung Chull; Jeong, Myung Ho

doi:10.1016/j.amjcard.2008.06.022

Cited by 50 publications

(42 citation statements)

References 24 publications

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“…3 In a study with data from the Korean Acute Myocardial Infarction Registry, the highest level of mortality was observed for patients with the lowest BMI and the highest waist-to-hip ratio. 26 In the present study, neither waist circumference nor waist-to-hip ratio was associated with all-cause mortality. This finding was attributed to the body shape of elderly Asians, who are typically leaner than Caucasians.…”

Section: Discussionmentioning

confidence: 69%

Lean Mass Index: A Better Predictor of Mortality than Body Mass Index in Elderly Asians

Han

Kim

et al. 2010

J American Geriatrics Society

108

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OBJECTIVES:To evaluate the correlation between body mass index (BMI), body composition, and all-cause mortality in an elderly Asian population. DESIGN: A prospective observational cohort study with 3.5-year follow-up. SETTING: The Korean Longitudinal Study on Health and Aging Project for elderly residents in Seongnam City, Korea. PARTICIPANTS: Eight hundred seventy-seven subjects aged 65 and older for whom baseline body composition data was available. MEASUREMENTS: BMI, waist circumference, and body composition of each subject was evaluated. Body composition was examined using bioelectrical impedance analyses of measures, including lean mass (kg), fat mass (kg), and fat proportion (%). In addition, lean mass index (LMI, kg/m 2 ) was calculated by dividing lean mass by the square of height. Participants were divided into three groups: Group 1 (o25th percentile), Group 2 (25-75th percentiles), and Group 3 (!75th percentile) for BMI, waist circumference, body composition, and LMI. RESULTS: In the fully adjusted Cox proportional hazard model, BMI, waist circumference, and fat composition were not correlated with mortality, but higher lean mass and LMI were considered predictors of lower mortality when comparing Group 3 and Group 1 (in lean mass, relative risk reduction of 84%, 95% confidence interval (CI) 5 45-96%, P 5.004; in LMI, relative risk reduction of 69%, 95% CI 5 12-89%, P 5.03). CONCLUSION: The present study indicates that the recommendation of low BMI as a means of obtaining a survival advantage in the elderly is not supported. Instead, higher lean mass and higher LMI are associated with better survival in the elderly Asian population. J Am Geriatr Soc 58:312-317, 2010.

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Section: Discussionmentioning

confidence: 69%

Lean Mass Index: A Better Predictor of Mortality than Body Mass Index in Elderly Asians

Han

Kim

et al. 2010

J American Geriatrics Society

108

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“…In the comparative analysis of patients with hypopituitarism with age-and sex-matched control subjects, even after adjustment for BMI, waist circumference was significantly greater in the hypopituitary group and total serum testosterone was inversely related to waist circumference and waist hip ratio. Therefore, central obesity-a hallmark of metabolic syndrome [20]-and degree of androgen deficiency was suspected to be closely related in patients with hypopituitarism. These results were similar to those in normal aging males [21,22], and patients with diabetes [23,24].…”

Section: Discussionmentioning

confidence: 99%

Carotid atheromatic plaque is commonly associated with hypopituitary men

et al. 2010

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Hypopituitarism increases the risks of many cardiovascular conditions and therefore, patients with this disease are more prone to cardiovascular disease. To our knowledge, there have been few studies on carotid artery plaque in male patients with hypopituitarism in assessing cardiovascular risks. The aim of this study was to specifically compare carotid artery plaque while examining other major cardiovascular risk factors between male patients with hypopituitarism and control subjects. Forty male patients aged 30-70 years with hypopituitarism and forty age, sex-matched control subjects were recruited at the Yonsei University Severance Hospital, Seoul, Korea. Carotid intima media thickness (IMT) and atheromatous plaque, anthropometry, lipid profile, and pituitary hormones were assessed. Atheromatous plaque in the carotid arteries was observed more frequently in patients with hypopituitarism than age-and sex-matched control subjects (59.5% vs. 2.5%, P \ 0.01) without differences of carotid IMTs. Patients with hypopituitarism also exhibited higher waist circumference, waist to hip ratio, total cholesterol and LDL cholesterol than control subjects. In subgroup analysis in male patients with hypopituitarism including GH deficiency, lower testosterone levels were associated with higher waist circumference (r = 0.446, P = 0.033).In conclusion, hypopituitary males exhibit an increased incidence of carotid artery plaque without differences of carotid IMTs, central obesity and higher total cholesterol level. Lower testosterone levels were associated with central obesity-a strong component of a metabolic syndrome, and unsubstituted testosterone deficiency might be an important cardiovascular risk factor in patients with hypopituitarism.

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“…In acute STEMI, patients with increased WHR more frequently have heart failure and WHR ≥0.90/0.85 is an independent predictor of six-month mortality 24 . In our study, where a small number of patients with normal WHR was found as expected, the presence of increased WHR was associated with signifi cant stenosis of proximal/middle coronary segments, but without signifi cant diff erences in other severity and in all prognostic parameters.…”

Section: Discussionmentioning

confidence: 99%

The Role of Anthropometry in Acute St-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Jelavić¹,

Babić

Pintarić³

et al. 2016

ACC

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SUMMARY -Th e aim of this study was to investigate the controversial infl uence of anthropometry on clinical severity and prognosis of acute ST-elevation myocardial infarction (STEMI). We prospectively analyzed 250 patients with acute STEMI treated with primary percutaneous coronary intervention (September 2011 -September 2012. Th ey were grouped according to the following anthropometric parameters: body mass index (BMI) (<25.0, 25.0-29.9, ≥30.0 kg/m²), waist circumference (WC) (<102/88, ≥102/88 cm), waist-to-hip ratio (WHR) (<0.90/0.85, ≥0.90/0.85) and waistto-height ratio (WHtR) (<53/49, 53/49-62/57, ≥63/58). Th e groups were analyzed by baseline, as well as severity (clinical, laboratory, echocardiography, coronary angiography, in-hospital complications) and prognostic parameters (major adverse cardiovascular events and sick leave duration during 12-month follow up). Patients with BMI <25.0 kg/m 2 had the highest rates of dyspnea and those with BMI ≥30.0 kg/m² had the longest hospitalization and widest stents; patients with WHR ≥0.90/0.85 had higher rates of signifi cantly stenosed proximal/middle coronary segments, while those with WHtR ≥63/58 had the highest rates of heart failure and total in-hospital complications (p<0.05). BMI <25.0 kg/m 2 increased (odds ratio (OR) 2.00, confi dence interval (CI) [1.09-3.68], p=0.026) and BMI 25.0-29.9 kg/m 2 reduced (OR 0.52, CI [0.30-0.91], p=0.022) the risk of dyspnea; WHR ≥0.90/0.85 increased the risk of signifi cant proximal/middle coronary segment stenosis (OR 3.34,.86], p=0.029) and WHtR ≥63/58 the risk of heart failure (OR 2.05, CI [1.13-3.71], p=0.017) and total in-hospital complications (OR 1.94,], p=0.017) (p<0.05). In conclusion, WHR and WHtR are better anthropometric parameters than BMI in predicting acute STEMI severity, while WC has no infl uence on it. Anthropometry has no infl uence on prognosis.

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Impact of Body Mass Index and Waist-to-Hip Ratio on Clinical Outcomes in Patients With ST-Segment Elevation Acute Myocardial Infarction (from the Korean Acute Myocardial Infarction Registry)

Cited by 50 publications

References 24 publications

Lean Mass Index: A Better Predictor of Mortality than Body Mass Index in Elderly Asians

Lean Mass Index: A Better Predictor of Mortality than Body Mass Index in Elderly Asians

Carotid atheromatic plaque is commonly associated with hypopituitary men

The Role of Anthropometry in Acute St-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

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